Assemblyman Robin Schimminger (D-Erie County) this week re-introduced the “Medical Liability Reform Act”, A.4381. The bill would enact a number of important provisions to control the outrageously high cost of liability insurance that physicians must pay in New York State, costs that if left unaddressed will continue to exacerbate existing access to care difficulties across New York State.

Provisions contained within the bill include: a $250,000 cap on non-economic damages in medical liability actions; requiring a physician consulted for a Certificate of Merit necessary for the initiation of a lawsuit to sign an affidavit; assuring that defendants in medical liability actions are only responsible for their proportionate share of fault; and requiring the disclosure of the identity of an expert witness who will testify in a medical liability action.

After two years of legislatively enacted rate freezes, medical liability insurance premiums were permitted by the Superintendent of Insurance in July 2010 to be increased by an average of 5%. For some specialists in some regions of New York, the increase was close to 9%. These increases are on top of the 55-80% increases in premiums paid by New York?s physicians from 2003-2008, bringing the premiums paid by many specialists in New York to amounts in the hundreds of thousands of dollars. These exorbitant costs are unsustainable.

As part of MSSNY?s presentation to the Governor?s Medicaid Re-Design Team, it was noted that as New York struggles to identify ways to address the $10 billion Budget deficit, we can no longer tolerate the excesses of a failed medical liability adjudication system. One way to reduce the extraordinary Medicaid cost burden to our State would be to better contain the liability costs facing physicians, hospitals and indeed, all health care providers. Not only would this reduce direct liability insurance costs, it would also reduce the very significant and well-documented costs of defensive medicine.

Co-sponsors of this important legislation include Assembly members: Magee, Reilly, Tobacco, Kolb, Barclay, Castelli, Crouch, Galef, Hawley, J. Miller, and Towns.

MSSNY applauds Assemblyman Schimminger as well as the co-sponsors for advancing this legislation to protect patient access to New York?s health care system. Physicians may use MSSNY?s Grassroots Action Center to send a letter to their elected representatives both on the state and federal level in support of liability reform by clicking here: http://capwiz.com/mssny/issues/alert/?alertid=23829501&type=ML&show_alert=1

I want to take the liberty of telling you about the Drexel Medicine Physician Refresher/Re-entry Course, which may be of particular interest to international medicall graduates of any physician seeking Read More (pdf)

The Centers for Medicare and Medicaid Services (CMS) released Final Rules defining the initial requirements physicians must meet to be eligible for the electronic health records (EHR) incentive program that begins in 2011. Rules were also issued on the technical capabilities required for certified EHR technology.

The 2009 stimulus package included money for physicians and hospitals to help off-set the cost of adopting EHR, as much as $26 billion in incentive payments over 10 years. Under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, eligible professionals could receive as much as $44,000 in incentive payments under Medicare and $63,750 under Medicaid. Hospitals could get millions of dollars under both programs Read More (pdf)

Click on image to view or Click Here

While we have not yet reached the end of one of the most difficult and contentious regular legislative sessions in memory, MSSNY has already achieved many high priority legislative victories. Among the most important of these victories is the enactment last month of legislation to re-institute the requirement that the State Insurance Department review and approve the health insurance premium rates charged by health insurance companies. Importantly, the bill would also increase to 82% the minimum medical loss ratio that health insurance companies must meet in the small group and individual market health insurance policies they offer.Read More (pdf)

On the last business day before they were to begin enforcing the Red Flags Rule, the Federal Trade Commission again extended the deadline – this time until December 31, 2010. The Red Flags Rule was promulgated by the FTC to address the risk of identity theft. In announcing the latest delay, FTC Chairman Jon Leibowitz blamed Congress for the uncertainty concerning the Rule. According to Leibowitz:

“Congress needs to fix the unintended consequences of the legislation establishing the Red Flags Rule – and to fix this problem quickly. . . . As an agency we’re charged with enforcing the law, and endless extensions delay enforcement.” Read More

Docs’ insurance-financing reforms to include state surcharge on homeowner and auto policies. Tort reform not part of mix, however.

New York will soon get a look at a long-awaited proposal for reforming medical malpractice insurance. With a two-year state moratorium on rate hikes for medical malpractice insurance due to expire July 1, a new package of proposals is floating in Albany’s executive branch.

Tort reform is not currently included in the package, but a $362 million surcharge on homeowners’ insurance and auto insurance is part of the deal. And although doctors will likely see lower increases than they had feared, they will not get a hoped-for $87 million state subsidy that would have reduced premiums.

April 6, 2010 — 3:30pm ET | By Caralyn Davis

WellPoint/Anthem is difficult to deal with, “incredibly bureaucratic” and pays poor rates. But UnitedHealthcare gets top honors as the worst healthcare payer for the fourth year in a row, according to the annual “National Payor Survey,” which asked 225 hospital and healthcare executives to rank seven national healthcare payers.

Sixty-five percent of respondents rated UnitedHealthcare negatively for how it deals with hospitals and said the company has a negative image and reputation.

“It’s clear that hospital executives are frustrated,” says Nathan Kaufman, managing director for Kaufman Strategic Advisors. “They see WellPoint/Anthem and other payers increasing their premiums upwards of 20 percent each year, yet reimbursement rates being offered to providers have stayed in the range of 3 to 5 percent. Health providers, and consumers, want to know where those extra dollars are going if not to pay for care.”

Aetna was ranked the top health plan for the third consecutive year. Sixty-eight percent of hospital and health system executives gave it high marks in payer image and reputation. Narrowly missing the top spot was Cigna, which received a 65 percent positive rating.

The survey targeted hospital leaders in the industry who negotiate managed care contracts with national health insurance companies and represented 24 percent of U.S. hospitals. It gathered data on hospital executives’ opinions about seven key insurers: UnitedHealthcare, Cigna, Aetna, Coventry, Humana, WellPoint/Anthem, and the local state or regional independent nonprofit Blue Cross Blue Shield plan.

This yearlong curriculum program is offered as a series of 17 robust and clinically engaging online CME/CE courses. Get clarity and guidance on key issues such as methodology for screening and diagnosis, optimal management strategies, and cultural differences in patient communication.

Activities in the Advanced Certificate Program IV are still available.

Conference to Outline Major Funding Available for NYC Primary Care Physicians

Primary care physicians in the five boroughs of New York City who want to take advantage of the significant funding available for installing electronic health records are urged to register for a special one-day program slated for Thursday, May 13 at the Brooklyn Marriott.

“The conference,” according to NYC Assistant Health Commissioner Amanda Parsons, MD, “is the most direct way for NYC primary care physicians and their office managers to determine if they qualify for up to $63,750 in funds for bringing their practices up to ‘meaningful use’ standards through use of electronic medical records. Attendees will be briefed on what they have to do to qualify and the array of services that NYC REACH, the federally designated ‘Extension Center’ for technical assistance is able to provide to help them get the funds.

In addition, they will be able to meet the companies which provide the electronic health records they will need.” There is no admission charge and continental breakfast and lunch are included. For further information and to register go to nyacp.org/EHRForm.